YOU AT YOUR BEST. HEALTH MATTERS.

Preventive Measures Can Minimize The Risk Of Varicose Veins

October 06, 1996|By Bob Condor, Tribune Staff Writer.

There are some common misconceptions about varicose veins. One is that the conspicuous veins are simply cosmetic imperfections. Another is that varicose veins are a function of age. A third is that compression stockings or surgery are the only solutions.

Wrong, wrong and wrong.

Varicose veins develop when there is a malfunction of tiny valves regulating blood circulation in the legs. The heart pumps blood through the arteries to the legs aided by gravity. Muscle contractions are needed to recirculate the blood up and against the force of gravity. The tiny valves do much of the recirculation work.

If the valve structure is weakened, the blood will often pool in the calf region. With nowhere to travel, the veins become a series of bulges.

But it is not just older people -- with less elastic skin to support veins -- who experience such breakdowns in blood vessels. You can be born with a valve structure (fewer valves or less sturdy ones) that predisposes you to problems. Doctors report treating patients ranging in age from teenagers to 80-year-olds.

Women outnumber men with varicose veins mostly because pregnancy puts them at greater risk due to pressure on the pelvic veins. Spider veins, the small reddish/purple branching that resembles the insect's spindly legs, are also more common in women; researchers point to the female hormone estrogen as a major catalyst for spider vein development during puberty and pregnancy.

Varicose veins are most evident among people with activities or jobs keeping them on their feet, or sitting, for many hours.

"I see a lot of nurses, flight attendants and hair stylists," says Dr. George Kuefner, an internist and director of the Vein Center of Orland Park. Kuefner says the most common myth among his patients concerns treatment.

"There is this preconceived notion that surgery is the only way," he says.

In fact, anyone with varicose vein tendencies can help prevent problems with weight control and regular exercise.

Other good ideas: If you stand or sit for large parts of the day, regularly flex your calf muscles. Sit with your legs up whenever possible. Compression stockings can ease leg aches and cramps. Also, avoid wearing uncomfortable shoes.

While lasers and a light-pulse machine called the Photoderm VL are attracting researchers to the field, a surgical procedure called stripping, in which veins are cut out or tied off, remains the only reliable treatment for larger veins in the legs. When a vein is removed or closed, blood then finds its way through other healthy veins.

Sclerotherapy is a less invasive technique that is effective for treating smaller, less developed varicose veins as well as spider veins and reticular veins (small blue-green veins behind the knee). It requires injecting a chemical solution into veins, making them collapse and disappear.

There are some drawbacks, says Dr. James J. Schuler, chief of vascular surgery at the University of Illinois at Chicago College of Medicine.

"It uses a harsh chemical. If it doesn't work, the skin can be chemically burned and discolored," Schuler says.

"Another thing is some doctors are charging a fortune for the service. You want to find an experienced physician with a good track record and reasonable prices."

Kuefner says his price range is about $300 to $2,500 depending on the case. Schuler says some clinics are asking even more.

He advises shopping around for a doctor with the best treatment success rate (ask for statistics and patient referrals) or waiting for newer laser therapies to be fine-tuned.

Laser treatments eliminate the potential for chemical burns. Photoderm VL is a laser-like machine that allows for different pulses of intense light to heat and destroy the veins.

"Once the bugs are worked out, these techniques are the future of varicose vein treatment," says Schuler. "They will be easier, faster and safer. But it might take a few years or more...any doctor using these techniques is still learning about them."